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The Basics

Shoulder tendonitis is a condition where the tendons of the shoulder are inflamed (either the rotator cuff or biceps tendon).

Tendons are tissues that connect muscle to bone. The rotator cuff consists of four tendons in the shoulder that help stabilize, lift, and rotate the arm. The biceps tendon connects the biceps muscle to the bones of the shoulder. It has two “heads” that connect to different bones of the shoulder. The biceps tendon long head connects to the glenoid (the socket of the shoulder) and goes through a very narrow space to do so. This can lead to the irritation and inflammation of the tendon.


Anything that causes the tendons of the shoulder to be pinched by surrounding structures can lead to shoulder tendonitis, from years of overhead activity to acute injuries. Years of overhead sports and jobs, or just doing a new repetitive overhead movement can cause this condition. It can also be caused by impingement syndrome, which occurs when the rotator cuff rubs against the bones of the shoulder.


Common symptoms of tendonitis include pain, stiffness, and swelling. If you have this condition, you may also experience a limited range of motion, tenderness, and night pains. These symptoms are similar to bursitis, which is another inflammatory condition.

Diagnosis and Complications

To diagnose these different inflammatory conditions that affect the joints, a medical history and physical examination will be performed. A physician can assess your pain and range of motion to rule out arthritis or other joint problems, as well as examine for swelling, redness, warmth. Tissue may be extracted from swollen bursa to check for gout or infection, while blood tests and imaging (X-Ray/MRI) may be taken to check for other conditions. A variety of conditions can factor into arthritis and bursitis, such as rheumatoid arthritis, diabetes, and gout, making the diagnosis complex. 


If untreated, tendonitis can develop into more serious conditions. It can increase the risk of tendon rupture, and if it continues for months it can lead to tenodesis, which is the chronic degeneration of the tendon. So, diagnosing the cause of shoulder pain can be important to preventing further issues.



The initial treatment for shoulder tendonitis includes, rest, ice, compression, NSAIDS, physical therapy, ultrasound therapy (biceps tendonitis), and activity modification. If these are unsuccessful, a cortisone injection or, in rare cases, surgery is considered. The surgery performed on rotator cuff tendonitis is arthroscopy, or open surgery in more severe cases. The surgical options for bicipital tendonitis include repair, biceps tenodesis (damaged part of tendon is removed and remaining part is attached to the humorous), and tenotomy. Tenotomy is reserved for severe cases, and is performed by releasing the biceps tendon from its attachment site. Individuals that do a lot of repetitive overhead motion are at risk for bursitis, as well as older people. Illnesses like diabetes, rheumatoid arthritis, kidney disease, and thyroid diseases are also associated with bursitis. 


To prevent subacromial bursitis, avoid or modify behaviors that put pressure on the shoulders. Wheel heavy loads, and take lots of breaks during activities involving heavy lifting. Exercise to strengthen the muscles of the shoulder joint, and warm up and stretch before activity of the shoulder.



Shoulder tendonitis is often caused by overuse. To prevent this issue, either avoid or modify repetitive overhead activities. Make sure you have good technique and posture during activities, stretch, and stop if an abnormal pain persists.